Perampanel

Definition

Perampanel is an antiepileptic medication used primarily for the treatment of epilepsy and seizures, specifically focusing on partial-onset seizures and primary generalized tonic-clonic seizures. It functions as a selective antagonist of the AMPA receptor, which is a subtype of glutamate receptor in the brain, helping to reduce neuronal excitability and seizure activity.

5 Must Know Facts For Your Next Test

1. Perampanel is marketed under the brand name Fycompa and was approved by the FDA in 2012.
2. It is taken orally and has a long half-life, allowing for once-daily dosing, which can improve patient compliance.
3. Common side effects include dizziness, somnolence, fatigue, and irritability, while more serious risks involve aggression and mood changes.
4. Unlike many other antiepileptic drugs, perampanel is not associated with significant interactions with liver enzymes, making it easier to manage in patients on multiple medications.
5. Perampanel can be used as an adjunctive therapy for patients who do not achieve adequate seizure control with other medications alone.

Review Questions

• How does perampanel's mechanism of action differentiate it from other antiepileptic drugs?
  • Perampanel stands out among antiepileptic drugs due to its specific action as a selective antagonist of AMPA receptors. While many antiepileptic medications focus on enhancing inhibitory neurotransmission or modulating sodium channels, perampanel directly targets excitatory pathways by inhibiting glutamate-mediated synaptic transmission. This unique mechanism allows perampanel to effectively reduce seizure frequency in patients whose conditions may not respond well to other treatments.
• Evaluate the safety profile of perampanel compared to traditional antiepileptic medications.
  • Perampanel has a distinct safety profile that includes some unique side effects, such as increased aggression and mood swings, which can be more pronounced than those seen with traditional antiepileptic drugs. However, it is less likely to interact with liver enzymes compared to many older AEDs, reducing concerns about polypharmacy in patients requiring multiple medications. While the side effects may raise concerns for some patients, its once-daily dosing and efficacy in treatment-resistant cases provide compelling reasons for its use.
• Critically assess the implications of using perampanel as an adjunctive therapy for epilepsy management.
  • Using perampanel as adjunctive therapy can significantly enhance seizure control in patients who have not achieved adequate results with monotherapy. Its unique mechanism of inhibiting AMPA receptors provides a complementary approach to traditional treatments that target different pathways. This strategy may lead to better overall management of epilepsy; however, clinicians must weigh the potential for adverse effects and patient tolerability. Additionally, understanding individual patient profiles will be essential to optimize treatment plans and improve quality of life for those living with epilepsy.

Related terms

AMPA Receptor: A type of glutamate receptor that mediates fast synaptic transmission in the central nervous system, playing a key role in synaptic plasticity and excitatory neurotransmission.

Seizure: A sudden, uncontrolled electrical disturbance in the brain that can cause changes in behavior, movements, feelings, and levels of consciousness.

Antiepileptic Drugs (AEDs): Medications used to prevent and manage seizures in individuals with epilepsy, which work through various mechanisms to stabilize neuronal activity.